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In most countries, especially those with advanced economies and relatively sophisticated medical services, poisoning with medicinal compounds is common. In many such counties, poisoning with therapeutic substances exceeds deaths from other types of toxic agents, especially in suicidal and accidental poisoning. This is explained by the ease of access of such substances, whether they are obtainable from a doctor on prescription or on demand across the counter of a pharmacy. Where state- sponsored health services exist, the cost to the recipient may be minimal or absent and this ease of access contributes to opportunities for self-poisoning, whether it be deliberate self-destruction, suicidal gestures or accidental ingestion - the latter especially in children. Unfortunately, overprescribing or the supply of too great a quantity of drugs at one time allows excessive stocks of drugs to be easily available to the public. Though only a minority of victims of medicinal poison- ing fail to rec...

   As always, an adequate history may give the clue to the cause of death. Where the circumstances are obvious, such as a death in a car with a tube leading from the exhaust, the pathologist's attention will be directed towards carbon monoxide from the outset. There are many other circumstances, however, in which the history may be obscure, and only the vigilance of the pantologist and his staff will pick up the possibility of this type of toxicity. In fact, many a case has first been recognized by the mortuary technician who commented on the colour of the skin or tissues. A number of fatal monoxide poisonings have already been certified as 'natural causes' by uncritical clinicians (especially in general practice) when in fact carbon monoxide poisoning, either suicidal or accidental, was the true reason for the death. Failure to examine the body fully is the usual cause, as the pink coloration may only be noticeable in the areas of postural hypostasis not normally visible...